Posts Tagged With: How Doctors Think

Day 400: Expected Numbers

First of all, dear readers, I want to acknowledge the number of my post today.

I made it to Day #400!   Yay!!

Image 1

When I started this blogging journey, my goal was to make it to Day #365, with no expectations of ever getting into the Four Hundreds.

Which reminds me of a story, ladies and gentlemen. The timing for this story is pretty darn good, since I told this story at my 60th birthday party, almost exactly a year ago.

The story is about ….

Me and My Cardiologist

My cardiologist’s name is Dr. Deeb Salem.  He works at Tufts Medical Center.  Here’s a photo of him:

Image 2

I could tell lots of stories about Dr. Salem, since I’ve been working with him since 1980, when I was 27 years old. I’ve already written about him here, on Day 62 (credited) and Day 275 (uncredited).

I just checked to see if there’s a Wikipedia page about Dr. Salem. I found that while Dr. Salem doesn’t have his own Wikipedia page (which surprises me), he shows up on a page titled How Doctors Think, which is a book by Dr. Jerome Groopman. I don’t want to go too deep into this digression, but I will quote from that page, as follows:

Salem’s challenge

Groopman spends a great deal of the book discussing the challenge posed to him by Dr. Deeb Salem, chairman of the Department of Internal Medicine at Tufts-New England Medical Center, during a presentation the author made at their hospital grand rounds. During the presentation, Groopman was discussing the importance of compassion and communication in providing medical care when Salem posed the following question:

“There are primary care physicians in every hospital who speak with great sensitivity and concern, and their longtime patients love them, but clinically they are incompetent–how is a patient to know this?”

This is what I find ironic about THAT:  a lot of Dr. Salem’s patients love him, 3 including me.  But I understand why Dr. Salem may have asked that particular question.  He is not only lovable, he is EXTREMELY competent. Believe me, I know.

Anyway, back to the story I told at my 60th birthday party.

I will set the scene, with the cast of characters. I had invited Dr. Salem to my 60th birthday party and I planned to tell this story, at some point during the festivities.  Soon after he had arrived with his wife, I found the two of them chatting with some other Very Important People in my life. I joined the conversation and told my story, as follows:

When I was 44 years old, and about three months pregnant with my son, my then-husband was experiencing some medical problems. He wanted to spend time, on a Saturday, at the Boston University Medical Library, researching his symptoms. Since I hadn’t brought anything else to read there, I became bored, so I decided to look up the latest research about my very rare medical condition, Congenitally Corrected Transposition of the Great Vessels. 4

And what I found, that day, totally freaked me out.

I found published medical articles that said:

  1. Women with my condition should NOT get pregnant.
  2. Most people with my condition were not expected to live past their 40’s.

You can probably imagine how I felt, reading those, that day.

Very soon after that, I called Dr. Salem and told him what I had found. And I know I was having many feelings, during that phone conversation, including fear. And anger, too. I remember crying and perhaps raising my voice, a little 5 on the phone.  The gist of what I was saying was:

What am I supposed to think about all this? And why didn’t you tell me these things before?  I’m 44 years old and three months pregnant!  Arrrghhhh!!!! 6

And this is how Dr. Salem responded, on that day on the phone with me, in 1997.  He said, very calmly,

Ann, you have an incredibly rare condition.  Every article published about your condition uses a very small sample size. So the results are suspect.

And Dr. Salem told me some specifics about the articles I had read.  While these details were somewhat reassuring, I cut to the chase:

Let me ask you this, okay?  Am I going to make it to age 50?

Dr. Salem immediately said,

Yes, Ann.  I look forward to celebrating your 50th birthday with you.

I immediately shot back,

What about my 60th birthday?  Will you be celebrating that with me, too?

And because I am very observant of subtle reactions in people, I noticed that Dr. Salem paused and took a breath, before responding, more slowly this time:

Yes, Ann. I expect to be celebrating your 60th birthday with you.

And, my punchline, as I was telling this story to Dr. Salem, his wife, and other VIP’s at my 60th birthday party was …

And here we are!!!

But, as usual, Dr. Salem had an even better punchline.  He laughed and said, “I remember that conversation.  I was wondering if I was still going to be around for that.”

And Dr Salem, his wife, and other VIPS in my life celebrated, that day, that we were all very much alive.

So why am I finally7 telling you this story today, dear readers?

Because, tomorrow I’ll be seeing Dr. Deeb Salem for my annual cardiology visit. And it’s the first time I’m seeing him since I left the hospital, a few months ago, after developing atrial fibrillation and being prescribed anti-coagulant medication, probably for the rest of my life.

And, honestly, I have some fears about this appointment.  I’m going to be asking him some difficult questions. And, as always (because I’ll be getting some tests that day, too), I might be hearing some difficult answers.

However, I may very well be catastrophizing, right now:  looking into the future and imagining the worst.

I’ve got an idea!  Maybe I’ll ask him about my 70th birthday party!

Thanks to Dr. Salem (obviously) and to you (of course!!) for reading today.


1  This photo has shown up several times before, including this post and this post.  And in case anybody is wondering…. NO! I have not gotten any further in developing my brilliant product idea of Neat Confetti.

2  I found this photo here.

3  Believe me, I know.  I’ve seen it, over the years, in many circumstances, including a dinner honoring him about five years ago, which I attended (and where many patients talked about their positive experiences of him).

4  See here, for my most detailed blog post about my heart condition.

5  I raised my voice only a little because other people were around me AND I have a little trouble expressing anger (as I wrote about, yesterday). Although, come to think of it, I feel pretty safe expressing all my feelings to Dr. Salem.

6   Or words to that effect.

7   I could have sworn I already told this story, in a previous blog post. But …. NO.

(I’ve forgiven WordPress.  I was angry at it earlier for throwing in unexpected numbers for the footnotes, which I’ve now fixed. C’est la vie, right?)

I’m mad at WordPress again. Unexpectedly, it changed the date of this post from the correct one, February 4, to February 2. While it might be fun to time travel two days back to my birthday, this screws up the order of my posts. The authorities have been alerted. (And they — and other bloggers — helped me fix it, on 2/5.  Yay!)

Categories: inspiration, personal growth | Tags: , , , , , , , , , | 50 Comments

Blog at WordPress.com.